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急诊出院之前有必要给静脉抗生素吗?
原作者: Bryan Hayes,江利冰 译 肖 文章来源: 《中华急诊医学杂志》编辑部 发布日期:2014-12-17

 Title: Is that IV antibiotic dose before ED discharge really necessary?
题目:急诊出院之前有必要给静脉抗生素吗?
Author 作者: Bryan Hayes
翻译:江利冰 校对:肖锋

Many of the oral antibiotics prescribed in the ED have good bioavailability. So, a one-time IV dose before discharge generally won't provide much benefit.
In fact, a new prospective study found that a one-time IV antibiotic dose before ED discharge was associated with higher rates of antibiotic-associated diarrhea and Clostridium difficile infection. [1] One-time doses of vancomycin for SSTI before ED discharge are also not recommended.

在急诊科开具的很多口服抗生素均具有很好的生物利用度。因此在急诊出院之前使用一次剂量的静脉内抗生素常常是不会取得很多益处的。实际上,一项新的前瞻性研究发现在急诊出院之前使用一次剂量静脉内抗生素和抗生素相关的腹泻和难辩梭菌感染的高发生率有关。也不建议对软组织感染在急诊出院之前使用一次剂量的万古霉素。

Bottom Line 要点

Though there are a few exceptions, if a patient has a working gut, an IV dose of antibiotics before ED discharge is generally not recommended and may cause increased adverse effects.
尽管有一些例外,如果一位患者的胃肠道功能良好,通常不建议在急诊出院之前静脉给抗生素,因其可能会增加不良反应的发生率。

References 参考文献
Haran JP, et al. Factors influencing the development of antibiotic associated diarrhea in ED discharged patients home: risk of administering IV antibiotics. Am J Emerg Med 2014;32(10):1195-1199.

文章来源:《中华急诊医学杂志》编辑部